Arthroscopic surgery, or arthroscopy, is a minimally invasive procedure to view, diagnose and treat problems inside a joint. Premier surgeons can directly view the joint using a high-tech camera instrument called an arthroscope. The arthroscope has revolutionized the field of orthopaedic surgery, especially in the care of sports and recreational injuries. It allows surgeons to directly visualize the interior of a joint via access through very tiny (keyhole-sized) incisions, and address torn or damaged structures that require repair or reconstruction.
Arthroscopy has significantly enhanced the quality of orthopedic care available to patients by allowing surgeons to perform the most modern and advanced techniques. A wide variety of conditions that previously required larger, more painful incisions and a longer time for recovery can now be performed with less discomfort and inconvenience to the patient. Recovery time is shorter and the incisions are more cosmetic due to their small sizes.
If appropriate for your condition, arthroscopic surgery can be performed for your knee, hip, ankle, wrist, elbow or shoulder. Arthroscopy can treat and relieve a variety of conditions including:
- Anterior cruciate ligament (ACL) tears of the knee
- Posterior cruciate ligament (PCL) tears of the knee
- Meniscus tears and baker’s cysts
- Loose cartilage bodies or osteochondral defects/injury
- Synovitis and joint inflammation
- Tibial spine fractures
- Instability: labral tears and shoulder dislocation
- Rotator cuff tears and strains
- Impingement syndrome and bursitis
- Bone spurs and calcific tendonitis
- Biceps tendonitis and tears
- Greater tuberosity fractures
- Femoroacetabular impingement (FAI) – “hip impingement”
- Labral tears
- Athletic groin pain and joint inflammation
- Snapping hip syndrome
- Gluteus medius/minumus tears
- Iliotibial band syndrome
- Cartilage injuries or loose bodies
- Elbow loose bodies/arthritis
- Osteochondral injuries
- Tennis Elbow (Lateral epicondylitis)
- Carpal tunnel surgery
- TFCC Tears of the wrist
- Ganglion cysts
The arthroscope was first used in the knee, and even today, the knee remains the most common joint for the surgery. In addition to documenting the source of your knee problems, much can be done therapeutically for the knee via arthroscopy.
Each knee contains two C-shaped cartilage shock absorbers known as menisci. The menisci are frequently torn and can be arthroscopically repaired or removed, depending on the type and location of the tear. Only the torn portion is removed, leaving the remainder to continue to act as an important shock absorber. In some instances of complete meniscus removal, especially in younger patients, a completely new meniscus can be transplanted.
The joint surface covering or cushion can become damaged or injured or worn out, as commonly occurs with arthritis. Newer techniques and technology can be used to regenerate focal areas of joint cushion damage, hopefully preventing future arthritis. Also, although arthritis cannot be fixed with arthroscopy, in selected cases, sometimes arthritic knees can be improved if there are significant symptomatic meniscal tears present or other treatable abnormalities.
A more recent advancement in knee arthroscopy involves the repair and/or replacement of certain internal ligaments within the knee. The anterior and posterior cruciate ligaments are important stabilizing ligaments that are commonly torn in athletes and active individuals.
Especially in the case of the anterior cruciate ligament (ACL), such a tear results in a “trick knee” that can buckle without warning, and easily be reinjured especially with sports. Although some individuals with this condition improve with rehabilitation alone, many have ongoing instability problems requiring surgical reconstruction of the ACL. This is especially true for active younger individuals who rarely can be managed successfully without ACL reconstruction. Arthroscopic techniques have improved the procedure greatly and allow the major portion to be done arthroscopically. Small incisions are still required to either harvest or insert the new ACL graft into the knee. This procedure has allowed a much quicker recovery, less pain and easier rehabilitation of this very common condition.
Arthroscopic techniques in the shoulder are similar to that in the knee in many ways. In the shoulder, the glenoid labrum, an important stabilizer (similar to the meniscus and the knee), is sometimes torn. It can be repaired or removed. Shoulder instability can also be fixed arthroscopically.
The rotator cuff muscles, which are involved with shoulder strength and mobility, are prone to fraying, inflammation and also tears. When they are irritated and pinched, the ailment is known as impingement syndrome. The arthroscope can be used to repair rotator cuff tears and remove any impinging tissue.
The hip joint is made up of the hip socket called the acetabulum, the ball portion of the joint called the femoral head, and an important section of collagen called the labrum which acts as a protective bumper around the joint. The surfaces of the joint are also covered in smooth cartilage which acts as a cushion when standing, walking or running. Loss of this protective layer of cartilage may lead to premature arthritis of the hip, which ultimately requires a hip replacement. However, if identified early, injury to the labrum and cartilage tissues can be addressed with hip arthroscopy which may help relieve pain and prevent or slow down the development of arthritis.
Hip Arthroscopy, sometimes referred to as a “hip scope,” is a minimally invasive hip surgery in which an orthopedic surgeon uses the latest technology and small fiber-optic cameras to address many causes of hip and groin pain in young athletes by looking directly into the hip joint.
The problems typically addressed with a hip scope include: hip labral tears, cartilage injuries, loose bodies/cartilage fragments, and femoroacetabular impingement (FAI), abductor tears and iliotibial band syndrome. Athletic patients with hip impingement or labral tears may experience symptoms such as: pain with running or prolonged sitting, popping or clicking in the hip, groin pain with deep flexion. Prior to the recent development of these arthroscopic methods, surgery for these conditions required extensive muscle dissection and a long incision. Now the same pathologies can be addressed through 2 or 3 keyhole sized incisions which makes the recover easier, faster, and typically less painful.
ELBOW, ANKLE & WRIST ARTHROSCOPY
In the elbow and ankle, the most common arthroscopic procedure involves the removal of impinging bone spurs and loose bodies or bone chips. Also, problems with the joint surface can be evaluated and addressed, similar to what is done and the knee. Tendon issues such as tennis elbow and golfer’s elbow can also be managed. In the ankle, torn ligaments can be tightened to manage instability or recurrent sprains. The wrist contains a small triangular fibrocartilage that is often torn in a fall on the outstretched hand. This too can be repaired, or removed if necessary, through the scope.
If you are interested in finding more whether arthroscopic surgery can help your condition, please schedule an appointment with a Premier Orthopaedic Surgeon.